Unintentional Epidural Anesthesia Mimicking Cauda Equina Syndrome from Suprafascial Injection of Liposomal Bupivacaine After Lumbar Foraminotomy: A Case Report. Issue 2 (April 2020)

• Record Type: Journal Article
• Authors: Bodendorfer, Blake M.; Shu, Henry T.; Lee, Catherine S.; Ivey, Jessica; Mo, Fred F.; Wall, Russell T.
• Is Part Of: JBJS case connector. Volume 10:Issue 2(2020)
• Publication Date: 2020-04
• Subjects: Orthopedic surgery -- Case studies -- Periodicals; Orthopedic surgery -- Periodicals; Orthopedics; Orthopedic Procedures; Orthopedic surgery; Periodicals; Electronic journals; Case studies; Periodicals; 616.7
• DOI: 10.2106/JBJS.CC.19.00605
• Languages: English
• ISSNs: 2160-3251

Abstract

Abstract : Case: This case report describes a 46-year-old woman undergoing right-sided L5 to S1 decompression who received liposomal bupivacaine (LB) for postoperative analgesia and developed unintentional epidural anesthesia with symptoms mimicking cauda equina syndrome. The patient's symptoms resolved 72 hours postoperatively, approximately the length that LB typically lasts. At the 16-month follow-up, the patient demonstrated complete neurological function with no lower extremity strength or sensation deficits. Conclusions: Tracking of LB into the epidural space after lumbar surgery may cause transient epidural anesthesia with symptoms that mimic cauda equina syndrome.